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Title: Multilevel factors affecting healthcare workers’ perceived stress and risk of infection during COVID-19 pandemic
Authors: Chua, GT
Tung, KTS
Kwan, MYW
Wong, RS
Chui, CSL
Li, X
Wong, WHS
Tso, WWY
Fu, KW
Chan, KL 
Wing, YK
Chen, EYH
Lee, TMC
Rao, N
Chan, GCF
Hon, EKL
Hung, IFN
Lau, KK
Wong, K
Xiong, X
Chi, S
Tang, S
Tam, PKH
Wong, ICK
Ip, P
Issue Date: Mar-2021
Source: International journal of public health, Mar. 2021, v. 66, 599408, p. 1- 9
Abstract: Objectives: This study aimed to identify key factors affecting Healthcare workers (HCWs) perceived stress and risk of contracting COVID-19 among themselves and their family members during the pandemic.
Methods: A cross-sectional online questionnaire study was conducted between 19 March and April 5, 2020 in Hong Kong. HCWs from public hospitals and private dentists, and their family members participated.
Results: A total of 747 HCWs and 245 family members participated. Higher perceived stress in HCWs was associated with more negative changes in family relationship (p = 0.025). The HCWs’ perceived stress, however, was positively associated with family cohesion (p = 0.033) and stress levels of family members (p < 0.001). The level of HCWs’ satisfaction toward the hospital policies in response to the COVID-19 outbreak was associated with lower levels of perceived stress and risk of themselves or their family members contracting COVID-19. HCWs’ previous frontline experience of SARS was significantly associated with less perceived risk of themselves or their family members contracting COVID-19.
Conclusion: Hospital policies addressing HCWs’ needs, frontline experience of SARS, and family relationship influenced psychological wellbeing of HCWs during the COVID-19 outbreak.
Keywords: COVID-19
Healthcare workers
Perceived stress
Psychological wellbeing
Hospital policies
Publisher: Frontiers Research Foundation
Journal: International journal of public health 
ISSN: 1661-8556
EISSN: 1661-8564
DOI: 10.3389/ijph.2021.599408
Rights: © 2021 Chua, Tung, Kwan, Wong, Chui, Li, Wong, Tso, Fu, Chan, Wing, Chen, Chun Lee, Rao, Chan, Hon, Hung, Lau, Ho, Wong, Xiong, Chi, Tang, Tam, Wong and Ip. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) ( The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
The following publication Chua GT, Tung KTS, Kwan MYW, Wong RS, Chui CSL, Li X, Wong WHS, Tso WWY, Fu KW, Chan KL, Wing YK, Chen EYH, Chun Lee TM, Rao N, Chan GCF, Hon EKL, Hung IFN, Lau KK, Ho MHK, Wong K, Xiong X, Chi S, Tang S-t, Tam PKH, Wong ICK and Ip P (2021) Multilevel Factors Affecting Healthcare Workers’ Perceived Stress and Risk of Infection During COVID-19 Pandemic. Int J Public Health 66:599408 is available at
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